SOUTHEASTERN SURGICAL GROUP PA (NPI# 1669552519) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669552519 |
| Entity Type | Organization |
| Organization Name | SOUTHEASTERN SURGICAL GROUP PA |
| Practice Address |
1401 Centerville Road Suite 100 Tallahassee FL 32308 |
| Practice Telephone | 8508775183 |
| Practice Fax Number | 8506561288 |
| Mailing Telephone | 8508775183 |
| Mailing Fax Number | 8506561288 |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2008-07-17 |
| Authorized Official Name | ROBERT D SNYDER (PRESIDENT) |
| Authorized Official Telephone | 8508775183 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| Street Address |
1401 CENTERVILLE ROAD SUITE 100 |
| City | TALLAHASSEE |
| State | FL |
| Zip Code | 32308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689634388 | Wade G Douglas | Surgery | 1401 Centerville Road, Suite 100, Tallahassee, FL 32308-3656 | 2006-03-25 |
| 1902353923 | Megan M May | Nurse Practitioner | 1401 Centerville Road, Suite 600, Tallahassee, FL 32308 | 2016-09-07 |
| 1780025635 | Tallahassee Memorial Healthcare Inc | Clinical Neuropsychologist | 1401 Centerville Road, Suite 504, Tallahassee, FL 32308 | 2013-07-08 |
| 1710120183 | Alexander Ramirez Valderrama | Surgery | 1401 Centerville Road, Suite 100, Tallahassee, FL 32308-4638 | 2009-04-14 |
| 1336218791 | Idella Anne Struk | Nurse Practitioner | 1401 Centerville Road, Suite 600, Tallahassee, FL 32308 | 2006-11-07 |
| 1265512883 | Richard L Zorn | Surgery | 1401 Centerville Road, Suite 100, Tallahassee, FL 32308 | 2006-10-17 |
| 1881787430 | Susan D Fischera | Nurse Practitioner | 1401 Centerville Road, Suite 100, Tallahassee, FL 32308 | 2006-10-02 |
| 1831282490 | Robert D Snyder | Surgery | 1401 Centerville Road, Suite 100, Tallahassee, FL 32308 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215588306 | Jmc Tallahassee, LLC | Preventive Medicine | 1838 Jacliff Court, Tallahassee, FL 32308 | 2019-09-20 |
| 1972165108 | Covenant Home Health Care, LLC | Home Health | 1921 Capital Circle Ne, Tallahassee, FL 32308 | 2019-07-09 |
| 1548735798 | North Florida Rehab Solutions | Hospitalist | 1675 Riggins Road, Dr Steele Lancaster, Tallahassee, FL 32308 | 2018-10-03 |
| 1013491596 | Injury and Rehab Centers of North Florida, LLC | Neuromusculoskeletal Medicine & OMM | 2268 Wednesday Street, Tallahassee, Florida, FL 32308 | 2018-09-20 |
| 1487133625 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 2634 Capital Circle Ne, Building C, Suite 156, Tallahassee, FL 32308 | 2018-08-08 |
| 1629566724 | Total Health & Wellness Home Care, LLC | Home Health | 1325 Mahan Dr., Tallahassee, FL 32308 | 2018-04-25 |
| 1669979480 | Beth North, Lcsw, LLC | Social Worker | 1325 Mahan Drive, Tallahassee, FL 32308 | 2018-04-09 |
| 1750885919 | Robert E Ashmore Jr Md | Obstetrics & Gynecology | 2770 Capitol Medical Blvd, Suite 100, Tallahassee, FL 32308 | 2018-03-22 |
| 1225547243 | William Michael Kunkle | Physician Assistant | 4004 Norton Ln, Suite 101, Tallahassee, FL 32308 | 2017-09-21 |
| 1235657834 | Traci R Raybon | Occupational Therapist | 1924 Hidden Valley, Tallahassee, FL 32308 | 2017-09-03 |
| Find all providers in zip 32308 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265792261 | Brett Michael Howard | Surgery | 1405 Centerville Rd Ste 4400, Tallahassee, FL 32308-4622 | 2012-05-23 |
| 1033399423 | John L Williams | Surgery | 4781 Williams Rd, Tallahassee, FL 32311-8523 | 2007-11-14 |
| 1023132024 | Herbert B Rubin | Surgery | 1460 Marion Ave, Tallahassee, FL 32303-5829 | 2007-03-17 |
| 1235223686 | Mahesh V Desai | Surgery | 3726 Wicklow Cir, Tallahassee, FL 32309-3216 | 2006-10-02 |
| 1447299979 | Shelby Larue Blank | Surgery | 1401 Centerville Rd Ste G02, Tallahassee, FL 32308-4638 | 2006-06-06 |
| 1306891239 | Al E. Deeb | Surgery | 1630 N Plaza Dr, Tallahassee, FL 32308-5346 | 2006-05-22 |
| 1689634388 | Wade G Douglas | Surgery | 1401 Centerville Road, Suite 100, Tallahassee, FL 32308-3656 | 2006-03-25 |
| 1063407104 | John Neal | Surgery | 2910 Capital Medical Blvd, Tallahassee, FL 32308-4408 | 2005-09-14 |
| 1790283133 | Tallahassee Memorial Healthcare Inc | Surgery | 1401 Centerville Rd Ste G02, Tallahassee, FL 32308-4638 | 2018-01-31 |
| 1174888549 | Tallahassee Memorial Healthcare Inc | Surgery | 1401 Centerville Rd, Suite 100, Tallahassee, FL 32308-4647 | 2012-07-11 |
| Find all providers in TALLAHASSEE | ||||
| City | TALLAHASSEE |
| Zip Code | 32308 |
Please comment or provide details below to improve the information on SOUTHEASTERN SURGICAL GROUP PA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.